Dr. Larry Earns

Guest Posts by Urgent Care Mentor

25 Jan, 2016

Let’s take a look at the two principal reasons that could motivate a health enterprise/hospital to deploy a specialized clinical application for your urgent care services.

Operational Metrics

The first primary driver is in helping to improve key operational metrics at your urgent care clinics (e.g. Door to Doc Time, Door to Door Times). The competitive pressures in the urgent care industry are real and growing. In addition to the already existing competition in your market, it is fair to assume that more urgent care clinics will be opening (e.g. national franchises). The costs associated with a “lost visit” in a pay-for-performance or risk contract is more than the loss of revenue associated with this one visit. There is also the cascading effect of what happens to the patient after discharge or transfer (i.e. Patient Leakage). To illustrate this point, the VP of ambulatory services at a large hospital network, studies hawkishly a weekly report that tracks both referral from PCP office (affiliated and non-affiliated) as well as any transfers outside of their network so that she can launch any corrective measures. A specialized application enables the providers to document far more efficiently, freeing up more time for patient interaction, streamlining clinical decision-making and thereby significantly improving patient satisfaction.

Pay for Performance

The second key driver is that your urgent care EMR needs to play a supportive role in helping you transition towards a pay-for-performance economic model. The key to success, as you transition away from the fee-for-service, is having a clinical decision support that helps providers select-steer them toward the right level of treatment and their leveling decision (i.e. whether to discharge, direct them to their PCP/specialty physician or have the patient transferred to the hospital’s emergency department). Embedded clinical decision support has proven to provide material financial benefits to risk-based healthcare systems by helping to assure that their patients are getting the right care at the right time and by the most cost-effective provider. This real-time decision support needs to be complimented by clinical intelligence that carefully measures provider variance in procedure utilization, performance and transfer selection to identify areas to reduce cost, increase reimbursement and improve patient outcomes on an individual provider basis.


Our healthcare system experience has shown that the preferred solution is to send the completed record (EHR-Discharge) back to the in-patient enterprise software (i.e. Cerner) and that record is then available for all to see in that service. Keeping the data active in the urgent care specialized app allows for more analytical work (business and clinical intelligence) since the data sent to Cerner may not be in discrete form but be more akin to a transcribed chart. Your ambulatory physicians will then have ready access to those records. As time progresses and Epic, Cerner or eCW move towards improved interoperability then the final EHR can be built – converted within the format, so the urgent care specialized EHR can be solely a clinical workflow, decision support and documentation tool that, once completed the “source of truth” (EHR in discrete form), will be fully transferred back to the enterprise software.

Dr. Larry Earl

Dr. Larry Earl

Dr. Larry Earl brings 3 decades of Urgent Care, Family Medicine and Occupational Medicine experience to guide patients.

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